Risicogewogen ziekenhuismortaliteit

Care providers should take charge of their own mortality rates

The publication of inadequately adjusted mortality rates has led to incorrect and unfair comparison of outcomes in quality of care between hospitals. In order to ensure adequate risk-adjustment of such outcomes, care providers should maintain their own registries. Such databases enable the monitoring and benchmarking of outcomes adjusted for case mix. One example is the Netherlands Association for Cardio-Thoracic Surgery database. The dataset consists of 18 risk factors for in-hospital mortality and the outcome in-hospital mortality for adult patients undergoing cardiac surgery in the Netherlands. More than 60,000 interventions have been included since 2007. The goal of the database is to control and to improve the quality of care by providing frequent feedback to the participating hospitals about their risk-adjusted mortality rates. Other care providers should follow this example and register their own risk-adjusted outcomes. Such registries will function as a quality instrument and will provide an in-depth explanation of the oversimplified results that are often published.

Conflict of interest: none declared. Financial support: the department of Cardio-Thoracic Surgery of the University Medical Center Utrecht received financial support from the Netherlands Association of Cardio-Thoracic Surgery to cover part of the first author’s salary.